In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4–8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1–1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability.

(1) Background: Hyperglycaemia that occurs during enteral nutrition (EN) should be prevented and treated appropriately since it can have important consequences for morbidity and mortality. However, there are few quality studies in the literature regarding the management of EN in this situation. The objective of this project was to attempt to respond, through a panel of experts, to those clinical problems regarding EN in patients with diabetes or stress hyperglycaemia (hereinafter referred to only as hyperglycaemia) for which we do not have conclusive scientific evidence; (2) Methods: The RAND/UCLA Appropriateness Method, a modified Delphi panel method, was applied. A panel of experts made up of 10 clinical nutrition specialists was formed, and they scored on the appropriateness of EN in hyperglycaemia, doing so in two rounds. A total of 2992 clinical scenarios were examined, which were stratified into five chapters: type of formula used, method of administration, infusion site, treatment of diabetes, and gastrointestinal complications. (3) Results: consensus was detected in 36.4% of the clinical scenarios presented, of which 23.7% were deemed appropriate scenarios, while 12.7% were deemed inappropriate. The remaining 63.6% of the scenarios were classified as uncertain; (4) Conclusions: The recommendations extracted will be useful for improving the clinical management of these patients. However, there are still many uncertain scenarios reflecting that the criteria for the management of EN in hyperglycaemia are not completely standardised. More studies are required to provide quality recommendations in this area.

Malnutrition is common in chronic obstructive pulmonary disease (COPD) patients and is associated with worse lung function and greater severity. This review by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) addresses the nutritional management of adult COPD patients, focusing on Morphofunctional Nutritional Assessment and intervention in clinical practice. A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, followed by critical appraisal based on Scottish Intercollegiate Guidelines Network (SIGN) guidelines. Recommendations were graded according to the European Society for Clinical Nutrition and Metabolism (ESPEN) system. The results were discussed among GARIN members, with consensus determined using a Likert scale. A total of 24 recommendations were made: 2(A), 6(B), 2(O), and 14(GPP). Consensus exceeded 90% for 17 recommendations and was 75–90% for 7. The care of COPD patients is approached from a nutritional perspective, emphasizing nutritional screening, morphofunctional assessment, and food intake in early disease stages. Nutritional interventions include dietary advice, recommendations on food group intake, and the impact of specialized nutritional treatment, particularly oral nutritional supplements. Other critical aspects, such as physical activity and quality of life, are also analyzed. These recommendations provide practical guidance for managing COPD patients nutritionally in clinical practice.

PREVENTION OF ORAL MUCOSITIS SECONDARY TO ANTINEOPLASTIC TREATMENTS IN HEAD AND NECK CANCER BY SUPPLEMENTATION WITH ORAL GLUTAMINE

Home enteral nutrition (HEN) is recommended for patients with nutritional requirements who can stay outside the hospital environment. HEN guidelines recommend assessing health-related quality of life (HRQoL) to evaluate the effect of the treatment. In this context, NutriQoL^® is a specific questionnaire developed to assess HRQoL in patients receiving HEN and validated in Spanish population. This was a prospective observational study was conducted in two Spanish hospitals to record and describe the evolution of HRQoL, in patients receiving HEN in routine clinical practice using NutriQoL^®. Fifty-seven patients participated in the study, of whom 36 patients attended at least one visit during the 6-month follow-up period. Most of them were at risk or moderate malnutrition (61.1%) or showed severe malnutrition (27.8%) at baseline. The mean (SD) NutriQoL score obtained at baseline was 69.4 (12.6), which increased to 71.0 (14.6) and 71.8 (14.1) at 3 and 6 months of follow-up, respectively. Approximately 60% of patients had good HRQoL, while 25% had excellent HRQoL. At 6-months follow-up visit, 46.4% of patients had good HRQoL, and 32.1% excellent. Patients receiving oral HEN showed a higher score compared with those fed by a non-oral method/route. Proportion of patients at risk or with moderate malnutrition maintained at 6 months, and there were no patients with severe malnutrition, increasing the proportion of patients with normal nutrition to 38.5%. Additionally, physicians considered HRQoL evaluation useful for clinical practice. Limitations of the study include small sample size, and a loss follow-up after 6 months. The assessment of HRQoL evolution using NutriQoL in patients receiving HEN appears valuable, as it provides valuable insights contributing to a more comprehensive nutritional evaluation and enhancing holistic patient care.

Revista oficial de la Sociedad Española de Nutrición Parenteral y de la Sociedad Española de Nutrición. Está dedicada al estudio y divulgación de temas relacionados con la nutrición.